Cavity liners and bases are placed between dentin/pulp and a restoration to provide pulpal protection against chemical, electrical, thermal, and mechanical stimuli. Liners are thin layers (~1um) that form a barrier against residual reactants/fluids, while bases (~1mm) provide support and stress distribution. The need for liners depends on the restoration material - amalgam benefits more than composite which achieves bonding. Liners can provide pulpal medication through materials like zinc oxide-eugenol or calcium hydroxide. Newer adhesive techniques and materials have reduced the emphasis on pulpal medication in favor of chemical protection through sealing and adhesion.
Cavity liners and bases are placed between dentin/pulp and a restoration to provide pulpal protection against chemical, electrical, thermal, and mechanical stimuli. Liners are thin layers (~1um) that form a barrier against residual reactants/fluids, while bases (~1mm) provide support and stress distribution. The need for liners depends on the restoration material - amalgam benefits more than composite which achieves bonding. Liners can provide pulpal medication through materials like zinc oxide-eugenol or calcium hydroxide. Newer adhesive techniques and materials have reduced the emphasis on pulpal medication in favor of chemical protection through sealing and adhesion.
Cavity liners and bases are placed between dentin/pulp and a restoration to provide pulpal protection against chemical, electrical, thermal, and mechanical stimuli. Liners are thin layers (~1um) that form a barrier against residual reactants/fluids, while bases (~1mm) provide support and stress distribution. The need for liners depends on the restoration material - amalgam benefits more than composite which achieves bonding. Liners can provide pulpal medication through materials like zinc oxide-eugenol or calcium hydroxide. Newer adhesive techniques and materials have reduced the emphasis on pulpal medication in favor of chemical protection through sealing and adhesion.
Liners and bases are materials placed between dentin (sometimes
pulp) and the restoration to provide pulpal protection or pulpal response. Pulp protection against: 1. Chemical protection 2. Electrical protection . !hermal protection ". #echanical protection $. Pulpal medication Protective needs %or a restoration varies depending on the e&tent and location o% the restoration and the type or restorative material used. L'(E)*: +re relatively thin layers o% materials (1",pm) used to provide a barrier to protect the dentin %rom residual reactants di%%using out o% a restoration and-or oral %luids. which may penetrate lea/y tooth0restoration inter%aces. #ay provide pulpal treatment. some thermal and electrical insulation. !he need to liners is greatest with metallic restorations that are not well bonded to the tooth structure such as amalgam . while the composite and resin modi%ied 1'C are bonded to the tooth so it eliminates the need to liners 2(LE** the cavity is very close to the pulp and pulpal medication is needed. !ypes o% liners: 1.thin %ilm liners: A . Solution liners: varnishes. 2 0 $ 3m thic/. B . Suspension liners: 2,02$ 3m. 2.thic/er liners: also known as Cement liners: 2,,01,,, 3m (,.201mm) used %or thermal protection. pulpal medication. 4+*E*: oCement bases. typically 102 mm. o2sed to provide thermal protection %or the pulp and supplement mechanical support %or the )estoration by the stress distribution on the underlying dentin sur%ace e.g. %orces o% amalgam condensation. 5b6ectives o% pulpal protection: )eviewing the anatomy. physiology o% dentin 7 pulp comple&. *tructure o% dentin. )eaction o pulp to di%%erent stimuli: '% the insult is strong and near to the pulp. the odontoblastic processes are retracted rapidly and a thin local bridge o% hydro&yapatite crystals is %ormed at the site. *mear layer: 8uring cavity preparation with rotary instruments. some o% the cutting debris is compacted to the sur%ace that material /nown as smear layer9this layer is very e%%ective barrier so it is le%t when using a non0bonding restoration li/e amalgam. :owever. it is partially porous , ;. it can<t prevent slow long term di%%usion9that<s way the smear layer should be sealed with a layer o% liner. :andling o% smear layer (according to rest. mat. used): =ith amalgam >? leave it. =ith composite >? must be removed. !raditional liners (varnishes) could be used with recent amalgam restorations. but dentin and bonding systems can produce better e%%ect and replace the liners. *olution liners (varnish) Copal or natural resin dissolved in non0a@ueous volatile solvent. (ether. alcohol and acetone) upon drying it will produce a thin %ilm layer. +8A+(!+1E*: %le&ible 7 dry rapidly. 5n the other hand. thic/ %ilms tend to trap solvent during drying and become brittle. L+BE)* 5C A+)('*:: *ingle coating covers only $$; o% the sur%ace because the smear layer is moist and the varnish is hydrophobic..*5 + *EC5(8 L+BE) '* (EE8E8 *econd coat covers D,0D$; (.4. use o% varnishes decreased since 1EE, due to using o% 84*. desensitiFing agents. *uspension liners: *ame e%%ect 7 dry slowly 7 give thic/er %ilms. Constituents are suspended or dissolved in water. !hermal protection thic/er layer (2,02$ 3m) Cunctions o% Cavity liners: 1. Primary purpose protective seal o% e&posed dentin sur%ace. 2. Electrical insulation (with newly placed amalgam restoration) %rom the electrical circuts with restorations in ad6acent teeth. . !hermal insulation with metallic restoration 8egree o% insulation depends upon !hic/ness o% remaining dentin 2mm o% dentin or e@uivalent thic/ness o% insulating material should e&ist to protect the pulp. ". Pulpal medication (dentin bridging) 0Zno/E liner Ca (5:) 2 liner
Eugenol is slightly acidic. phenoloic compound that have an obtundant action on the pulp at low concentrations with mild to moderate pulpal in%lammation. (.4. high conc will be irritating to the pulp. ZnO/E liner. base. cement Gn5-liner %or moderately deep cavities because it is released during setting and over several days. (ow a days resin0modi%ied glass ionomer cement is used. Ca (5:)2 very deep cavities or microscopic E&posure Ca (5:) 2 Caustic (+l/aline. p: 12) *timulate secondary dentin %ormation !ypes 0 Ca (5:) 2 suspension 0 Chemically set material 0 Light0cured material Ca (5:) 2 dissolution or degradation overtime *etting reaction o% the ZnO/E and calcium hydroxide accelerated by moisture. Eugenol and calcium hydro&ide cannot be incorporated is the same %ormulation because eugenol rapidly chelates with calcium ions in a strong e&othermic reaction the choice o% eugenol0based versus Calcium0hydro&ide0based liner is based on the relative depth o% the tooth preparation. :istorical 4ac/ground: 4e%ore 1EH,<s Gn phosphate cement )ein%orced ZnO/E 1EI, polycarbo&ylate cement 1ED$01EE" 1lC LC1'C. compomers chemical adhesion. 1ood mechanical properties. %luoride release. command setting and rapid achievement o% strength. Previously 8eep cavity: J Ca (5:) 2 liner J 4ase %or mechanical support Kstress distribution. J Aarnish on the base plus walls e&cept when using Finc phosphate cement the varnish must be applied be%ore the cement. J +malgam Currently J Light cured Ca (5:) 2 liner J 1'C base Cor indirect restoration: J + base is used to bloc/ undercuts J Pre%erable to be bondable to dentin to prevent dislodgement during temporiFation and impression ta/ing. 0 Composition. structure and properties o% di%%erent cement bases. 0 Llaniputation Clinical consideration with liners and bases Clinical 6udgment depends upon: 1) )emaining dentin thic/ness ()8!) 2) Consideration o% adhesive material ) !ype o% restorative material use M in amalgam: 1.$ mm depth >? 2 layers o% varnish K amalgam M in composite: acid itch 7 primer 7 bonding agent? !:E +'#: to give chemical protection. M eugenol can<t be used under composite because it inhibits polymeriFation. M in case o% very thin )8! use spherical amalgam because it needs less %orces o% condensation. (ewer liners place less emphasis on pulpal medication and %ocus more on chemical protection by sealing. adhesion and mechanical protection. (ewer compositions rely on mechanically strong acrylic resin matrices. and that choice ma/es the release o% eugenol or calcium hydro&ide more di%%icult or impossible.. 8r. #osta%a